Individual
DR. BENNIE FRANK FORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
156 SAGE RD, BASTROP, TX 78602-5631
(512) 581-0931
(512) 581-0931
Mailing address
156 SAGE RD, BASTROP, TX 78602-5631
(512) 581-0931
(512) 581-0931
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G6014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137448005
—
TX
Enumeration date
05/04/2006
Last updated
03/23/2020
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